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Voriconazole photosensitivity causes apparent graft-versus-host disease exacerbation

Bone Marrow Transplantation volume 54, pages 323–325 (2019)Cite this article

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Antifungal prophylaxis or treatment is an integral component of allogeneic hematopoietic stem cell transplant (allo-HCT). For years, fluconazole was used for antifungal prophylaxis, and offers benefit of tolerability and lower cost. It, however, does not prevent aspergillosis and other invasive fungal infections [1]. Therefore, when broader coverage against fungal infections is required, next generation azoles (voriconazole, posaconazole, or isavuconazonium sulfate) are preferred.

Azole induced photosensitivity can cause significant health issues including development of skin cancers. The exact relative risk of photosensitivity among azoles is unknown. However, it appears that voriconazole may have a significantly higher incidence of photosensitivity (Table 1) [2, 3]. Sun avoidance is therefore recommended; photosensitivity subsides following cessation of voriconazole. Its long-term use has been associated with development of skin cancers, including malignant melanoma.

Table 1 Azole induced incidence of photosensitivity or skin rasha
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Authors and Affiliations

  1. Department of Hematology Oncology, Houston Methodist Hospital, 6445 Main St, Houston, TX, 77030, USA

    Akash Mukherjee

  2. Department of Pharmacy, Houston Methodist Hospital, 6565 Fannin St, Houston, TX, 77030, USA

    Ekim Ekinci

  3. Center for Cell and Gene Therapy, Baylor College of Medicine and Houston Methodist Hospital, Houston, TX, 77030, USA

    Audrey Scholoff, Gloria Obi, Ngoc Vu, George Carrum & Rammurti T. Kamble

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  1. Akash Mukherjee
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Correspondence to Rammurti T. Kamble.

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Mukherjee, A., Ekinci, E., Scholoff, A. et al. Voriconazole photosensitivity causes apparent graft-versus-host disease exacerbation. Bone Marrow Transplant 54, 323–325 (2019). https://doi.org/10.1038/s41409-018-0285-3

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  • DOI: https://doi.org/10.1038/s41409-018-0285-3

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